Breathing in Pilates and everywhere else is crucial on many levels. Proper breathing helps everything!

Breathing comes up a lot in the Pilates studio. In fact, one of the first exercises we teach new clients is the Hundred, which involves a whole lot of breathing in flexion.

Yesterday I taught a workshop on Teaching Clients with Hernia and Diastasis Recti to a group of wonderfully talented and bright Pilates teachers (thank you Enja, Juan, Andy, Charlotte, Margaret, and Tricia!). When you are dealing with overstretched or torn abdominal muscles, the interplay of breathing, thorax pressure, and intra-abdominal pressure (IAP) becomes very important.

Here is the science behind how we approach breathing in Pilates, and why we inhale to start many Pilates exercises.

(featured image from Siyavula Education on Flickr)

Basic Breathing Mechanics

Breathing is necessary to bring fresh oxygen into our bloodstreams via the lungs. Our lungs are very lightweight, flexible, and porous, like a sponge. My dog loves to eat dried beef lung as a treat, and it is spongy in texture.

Air moves from high pressure to low pressure. The thorax is set up as a pressurized container. The lungs sit inside the ribs, which are jointed to move and have flexible intercostal muscles in between that allow for expansion and contraction. At the bottom of the thorax is the diaphragm muscle, which also helps regulate the pressure of the thorax by allowing for expansion of volume.

When you inhale, the diaphragm and intercostals contract and expand the thorax. This expansion of volume lowers the pressure in the chest cavity below the outside air pressure, allowing air to flow in through the airways (from high pressure to low pressure) and inflates the lungs.

When you exhale, the diaphragm and intercostals relax, the thorax gets smaller, and the decrease in volume of the cavity increases the pressure in the chest cavity above the outside air pressure. Air from the lungs (high pressure) then flows out of the airways to the outside air (low pressure).

Does Breathing Effect Abdominal Pressure?

Now, below the diaphragm is your abdominal cavity, which houses a majority of our crucial internal organs. The sides of the abdominal container are made up of several layers of abdominal muscles, starting at the deepest layer with the transverse abdominus that wraps from your lumbar spine all the way to the front, continuing with the internal and external obliques that wrap around, and finishing with the six-pack, the rectus abdominus that attaches your breastbone to your pubic bones. All of these muscles meet at the linea alba, the line down the center of your abdomen. The bottom of this abdominal container is the pelvic floor, made up of several muscles that work, in part, to hold up our internal organs, control our sphincters, and keep us continent.

In a basic view of breathing, it would seem obvious that inhaling, while lowering thorax pressure, would increase intra-abdominal pressure as the diaphragm drops down. This would totally be the case if we weren't able to use our muscles, expanding our abdominal cavities and lowering our pelvic floors at the same time. It turns out that in normal, resting, supine breathing there is actually very little increase in IAP with inhalation. In fact, the increase in IAP comes during maximum voluntary breathing (like breathing in exercise, or any conscious breath work) at the moment that we start to exhale. Makes sense, right? That is the point where we need to use pressure to push out the air.

Maximum voluntary breathing was associated with marked changes in intra-gastric pressure which rose abruptly at the beginning of expiration and fell abruptly at the beginning of inspiration.

[Campbell, E. J. M., Green, J. H., (1953), The variations in intra-abdominal pressure and the activity of the abdominal muscles during breathing; a study in man. The Journal of Physiology, 122 doi: 10.1113/jphysiol.1953.sp004999.]

What About those Hundreds?

Position also has an effect on IAP. Flexion increases IAP by impeding the ability of the abdominal wall to lengthen, overhead pressing increases IAP, moving limbs increases IAP, and lifting heavy objects increases IAP.

Looking at flexion, much of the basic and beginner healthy-body Pilates exercises involve flexion (hundred, half roll or roll up, rolling like a ball, spine stretch, etc.) and pulling navel to spine. So we place a healthy body into a position of increased IAP and then ask that body to navigate breathing and moving of limbs. In a healthy body this is useful work.

In a body that has weakness in the abdominal wall, asking for deep respiration while in flexion and moving limbs is almost impossible and frustrating for the clients, since they cannot properly expand and contract the area to build up pressure for the exhale - that is when you see the doming or popping up of the internal organs.

What exercises are safe and useful? Exercises that focus on deep breathing and stability.

Breathing in Pilates

Many exercises in Pilates start with an inhale or use an inhale to prepare - we inhale to press out for footwork or down for pumping, we inhale out on short box, inhale to start our backstroke, stomach massage, our neck pull....

This should make more sense now, since the moment of the most intense work and pressure in the abdominal cavity is at the beginning of the exhale. Joe Pilates has us inhaling until we are the point where we need maximum effort to get back, and that is where we utilize that pressure of the exhale! Brilliant!

Learn more about my In and Up Diastasis Repair program here.

Pilates after Hernia Repair


Pilates after hernia repair offers a crucial piece of the exercise puzzle - pelvic floor and deep abdominal support!

Lately I have received several requests for exercise suggestions to help either repair small existing inguinal hernias, or assist in maintaining a hernia repair after surgery.

First of all, what is a hernia?

According to the NIH,

A hernia is a sac formed by the lining of the abdominal cavity (peritoneum). The sac comes through a hole or weak area in the strong layer of the belly wall that surrounds the muscle. This layer is called the fascia.

Basically, a hernia is an area where the intestines start to protrude through a weak area in the abdominal wall. Hernias are named for location (inguinal - groin, umbilical - belly button, hiatal - upper abdomen, femoral - upper thigh).

Hernias are caused by straining while abdominal pressure is increased - it can happen on the toilet, opening a window, or even lifting weights and/or doing abdominal exercises incorrectly.

Yes, you read that correctly. Poorly executed exercise can cause hernias and make existing ones worse.

However, correctly done exercise can help heal a hernia, especially after repair.

Exercise recommendations for pilates after hernia repair are similar to those for diastasis recti.

Once you have been cleared by your physician to exercise, it is important to avoid straining while increasing abdominal pressure. This requires careful monitoring of breathing patterns while moving and exercising.

At the beginning you should avoid most traditional abdominal exercises, such as crunches. You should also avoid overhead presses.

Focus on exercises that help engage your pelvic floor muscles, diaphragm, and deep abdominals.

Breathing correctly is the first challenge.

Listen to the first breathing exercise in my back pain video. This is the basis for moving correctly in any exercise.

5 Pilates Tips to Improve your Workout


Here are 5 Pilates tips that will improve your workout.

It's almost the end of January, and we are still seeing a steady stream of new clients coming into Real Pilates. Since I see so many newbies taking classes and privates, I thought I would give everybody five easy ways to improve your Pilates workout.

1. Don't press your lower back down constantly.

I know, you hear the words "scoop your belly" or "navel to spine" and it seems like you should be flattening your lower back all of the time.

Not true!

Your spine has a natural curve, and the lumbar vertebrae are built to curve slightly forward, towards your navel. So when we Pilates teachers say "pull you navel to your spine," we mean for you to keep that natural curve and just pull your abs closer to your spine - not flatten your curves!

2. Breathe consciously and often.

Most people I know tend hold their breath when exercising. This actually makes things harder instead of easier, and can put you more at risk for injury. Your ribs, which comprise a full half of your spine, move along with your breath. Your abdominal muscles help move the diaphragm and ribs to take full breaths, and I view breathing as a primary, basic abdominal exercise.

Since Pilates helps with spine mobility and abdominal strength, the breathing part is crucially important to the system as a whole.

If the prescribed breathing pattern doesn't work for you, ignore it and just breathe.

3. Keep it simple.

Most good Pilates teachers will offer several versions of an exercise, each a little more complex than the last. If the basic exercise is ridiculously hard, don't move on until the basic version feels do-able. Doing too much too soon can cause injury.

4. Work your back.

If you went by how people tend to characterize Pilates, you would think it is all abs and no back work.

Not so!

Joseph Pilates knew that all of the muscles in the body need strength. A weak back is just as bad as a weak front, and puts you at risk for injury.

5. Work your butt.

I see so many folks who have extremely weak gluteal muscles (butt muscles). Our glutes help to extend our hips (so important for proper gait in walking), support our legs, and keep our lower backs stable.

Use them! If your hamstrings always cramp when you bridge, for example, I guarantee that you are using your legs too much and not your glutes.

Keep these tips in mind during your next Pilates class, and you will have a more efficient and effective workout.

I Can't Find My Abs

Every day someone tells me that the problem with Pilates for them is that they can't find their abdominal muscles, either from disuse, abdominal surgery, or other stress. Short of having radar detectors to zero in on this area, focus and attention are the next best thing.

Start with breathing. Your abs assist the movement of your ribcage and therefore your diaphragm to help you breathe. And these muscles are not just in the front, but actually wrap around your torso back to front, forming and actual internal corset of strength and support.

So when you inhale let your ribcage expand in all directions and feel your abs relax. As you exhale feel your ribs and abs pull in towards your waistline. That movement is being done with the help of your abs - you have found them!

Breathing and Pilates

Image via Wikipedia

Something many people don't realize is that deep proper breathing in itself is a basic primary abdominal/core exercise. When we inhale our diaphragm stretches down towards the abdominal cavity, the pelvic floor muscles relax a bit, and the abdominal and back muscles stretch to allow the ribcage to expand and the lungs to fill with air (I always remind my pilates and fitness clients that their lungs are under our ribs and not in our abdomens). When we exhale the pelvic floor muscles tighten to push up, the diaphragm pulls up under the ribs, and the abdominal/back muscles contract to pull the ribs in and allow the air to be fully expelled.

If you are not breathing fully ever in your day you will suffer from tight (but not necessarily strong) abs, back muscles, and neck/shoulder muscles. You will find it more difficult to relax fully and may have problems with many exercises that involve moving your ribcage, shoulders, and thoracic spine. In severe cases it may affect your pelvic floor function and ability to hold your urine.

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Scoliosis & Pilates

Image via Wikipedia

In my years of teaching Pilates I have worked with many many clients with scoliosis. Some had full spinal fusions with Harrington rods, and some just managed on their own. Some where professional dancers and athletes who really had to work on their back and core strength in oredr to continue working, and then I also had just regular folks who discovered that Pilates kept them fit, safe, and in less pain.

Curves, Twists and Bends: A Practical Guide to Pilates for Scoliosis is a short introduction to Pilates/pre-Pilates exercises geared to non-exercisers with scoliosis. It is written by a scoliosis patient and her Pilates teacher, the UK based Alan Herdman. While very clear, basic, and simple, the exercises in this book are easy to grasp and easy to perform. They may be small and low impact, but will impact your body in a profound way, especially if you tend to shy away from exercise.

Note that this book is not a comprehensive guide to Pilates for scoliosis. It does not address more advanced Pilates mat and equipment exercises, and is not necessarily geared towards athletes and teacher/trainers. However, if you want a good understanding of scoliosis, it's physical and psychological effects on the individual, and a good quick basic self care program, this book provides all that and more.

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